Please complete this application form if you are interested in completing a Humane Fort Wayne Internship.

Internships are offered to High School and College students at our clinic location at 1333 Maycrest Dr.

Once you complete the form, please press "continue" at the bottom of the page to submit it.

Interns and Volunteers can be terminated if they do not abide by the rules and regulations set forth by Humane Fort Wayne.

Need further assistance? Contact Dani Wagner at dwagner@humanefw.org

Name and address

First name:

Last name:

Middle name:

Title:

Nickname:

Street 1:

Street 2:

Street 3:

City:

State:

* Zip: *

Home phone:

Cell phone:

Email address:

Date of birth:

School or organization you are completing this internship for?

Why do you want to intern for our organization?

(Other than a love for animals)

When does your internship need to begin and end?

Please list the days and times you want to intern.

Emergency Contact

First name:

Last name:

Home phone:

* OK to call here

Relationship:

Do you have any special skills or training?

Aside from having animals at home.

Internship opportunities you're interested in:

Humane Fort Wayne:

Business Administration

Surgery - Vet Tech

Surgery - Veterinarian

Wellness Clinic - Vet Tech

Wellness Clinic - Veterinarian

Do you have any limitations for certain tasks?

Please list any physical, emotional or mental limitations that may prevent you from performing certain tasks. If you would like to see a copy of our "Essential Capabilities for Volunteers," please contact dwagner@humanefw.org.

Humane Fort Wayne Release

By agreeing, I certify that the statements made in this internship application are true and correct and have been given voluntarily. I understand that I will not be paid for my services and that my service may be terminated at any time.

I Agree